Allied Health Final

Health care

Maintenance or improvement of health through the prevention, diagnosis, treatment, recovery or care of disease, illness, or injury

Cost containment

Control of the rising cost of health care while achieving the maximum benefit for every dollar spent

• Many factors contribute to rising costs

  • Technical advances

    • Highly technical procedures

    • Diagnosis tools

    • Computers and technology

  • Aging population

    • Need for more frequent health care services

    • Treatment of chronic conditions

    • More medications

  • Lawsuits

    • Expensive malpractice insurance

    • Unnecessary diagnostic tests

    • Defensive health care

Method of cost containment

• Diagnostic related groups (DRGs)

• Combination services

• Mass or bulk purchasing

• Outpatient services

• Early intervention and preventative services

• Energy conservation

Diagnostic related groups (DRGs)

Method of classifying diagnoses into specific payment categories

• Effort to reduce health care for government insurance plans (Medicare and Medicaid)

• Patients classified into payment groups

• Limit is placed on cost of care

• Health care agency receives set amount as payment

• Encourages health care facility to provide care within expense limit

Combination services

Health care agencies join together to share services to provide to a large number of people at a decreased cost

• Ex: large labs with computerized run test for several agencies at lower cost compared to smaller specialized labs

Mass of bulk purchasing

Buying necessary equipment in bulk to reduce costs

Outpatient services

Medical treatment without hospital admission

• Outpatient medical centers

• Reduces hospital stays and lowers cost of health care

• Outpatients surgery, X-ray, diagnostic tests, etc.

Early intervention and preventative services

Care before acute or chronic disease occurs

• Patient education, immunization, physical exams, etc.

Energy conservation

• Overall energy efficiency

• Maintaining systems and fixtures

Biotechnology

Use of genetic and biochemical processes of living systems to develop or modify useful products

• Expanding and diverse field

• Major impacts on the future of medicine

Genomics

The study of all the genes in the human genome (complete set of DNA)

• Analyze how genes are regulated, affected, and interact

Genomic testing

Use of tests to check for the presence of specific genes know to cause disease

• Allows for diagnostic and preventative testing

• Approved genetic tests for cancers, osteoporosis, etc.

Pharmacogenomics

Using a person’s genome to choose drugs and doses likely to work for the individual

• Personalized and precise medicine

Proteomics

Study of the structure and function of proteins

• Map protein function and regulation to understands disease

Stem cell research

Study of cells capable of becoming any type of specialized cell

• Stem cells can replace defective cells

• Embryonic (controversial)

Nanotechnology

Techniques to manipulate atoms and molecules to create new materials

• Devices to deliver medications to target locations

• Build structure to replace damaged sites

• Potential for artificial organ transplant

• Diagnostic services

Hospitals

• Major health care facility

• Range from basic to complex

• Can be private, religious, nonprofit, voluntary, or government run

• Can be education and research based

• Types of hospitals:

  • General hospitals - treat wide range of conditions and age groups; provide diagnostic medical, surgical, and emergency care

  • Specialty hospitals - provide care for special conditions or groups

    • Ex: pediatric, orthopedic,etc.

  • Government hospitals - operated by federal state, and local government agencies; care for government personnel

    • Ex: VA hospital

  • University or college medical centers - hospital services research, education; can be funded privately or through government resources

Long-term care facilities (LTCs or LTCFs)

Mainly provide assistance and care for the elderly, individuals with disabilities, or long-term illnesses

• Types of long-term care facilities

  • Residential care

  • Extended care or skilled care

  • Independent living and assisted living

Residential care

• Care for those who can no longer care for themselves

• Help with every day activities, promote social interaction

Extended care or skilled care

• Skilled nursing and rehabilitation care

• Recovery from surgery, cancer treatment, etc.

Independent living and assisted living

• Individuals who can care for themselves purchase or rent apartments

• Meals, housekeeping, transportation, and medical care provided (usually associated with residential care facility)

Medical offices

• Privately owned or corporations

• Diagnostics, treatment, examination, basic lab testing

• Primary care facilities or specialty (cardiac, pediatrics, dermatology, etc.)

Dental offices

• Privately owned or corporations

• General care of specialized care

• General: routine dental care, X-rays

• Specialized: orthodontics, endodonist

Optical centers

• Privately owned or corporation

• Routine exams, lends prescriptions, eye diseases

Clinics

Specialized outpatient health care facilities

• Types of clinics:

  • Surgical clinic - minor “one day” surgeries

  • Urgent or emergency care clinic - first aid or emergency care to I'll or injured individuals

  • Rehabilitation clinic - offer physical, occupational, speech, and other similar therapies

  • Substance abuse clinic - rehabilitation for alcohol and/or drug abuse

  • Specialty clinics - diabetic care, dialysis, oncology, etc.

Emergency care services

• Immediate care for accidents or sudden illness

• Ambulance services

• Some have helicopter (medivac) services

• Mostly operated by hospitals

Laboratories

• Often part of facilities

• Diagnostic tests

• Ex: blood test, urine test, etc.

Hospice

• Care for the terminally ill (6 months or less)

• In home or at hospice facility

• Palliative care (comfort and support)

Mental health facilities

• Treat patients with mental disorders and diseases

• Guidance and counseling centers, psychiatric clinics, abuse treatment centers

• Inpatient or outpatient

Pharmaceutical services

• Preparation and dispensing medications

Health insurance

Insurance coverage that pays for medical expense (whole or part)

• Health care expenses paid by insurance company

• Amount paid and services paid for depend on type of coverage

• Often offered as a benefit from place of employment

• Can purchase privacy policy

Premium

Amount of money that you or your employer pays per month for the insurance plan

• May be paid monthly or yearly

Deductible

Amount that must be paid by the patient for medical services before the policy begins to pay

• Must meet certain monetary requirement

• Resets yearly

Co-insurance

Requires that a specific percentage of expenses are shared by the patient and the insurance company, usually after deductible is met

Co-payment (Copay)

A predetermined amount of money a patient pays at the time of service regardless of the amount of the service

• Usually paid up front at time of visit

Out-of-pocket maximum

Limit of what a patient pays in one calendar year

Health maintenance organization (HMO)

Managed care for health services for a monthly fee

• Lower premiums

• Required to use only HMO-affiliated health care providers

• Must pay full cost of care if non-affiliated provider is used

• Low or no deductible, lower co-pays

Preferred provider organization (PPO)

Provides contract with certain health care agencies or doctors to provide health care at reduced rates

• Higher premiums

• More freedom to choose doctors/facilities

• Will pay for some or all out of network costs (cheaper in network)

• Higher deductibles and co-pays

Government insurance plans

• Run by centers for Medicare and Medicaid services (CMS)

• Medicare

• Medigap

• Medicaid

• Workers compensation

• Tricare

Medicare

Health care for individuals over 65 years old, or individuals with a disability who have received social security payments

• Different kinds of coverage (hospital, medical, etc.)

• Covers 80% of health care

• Must pay balance or use other insurance coverage

Medigap

Private insurance policies that cover what Medicare does not, supplement plans

Medicaid

Operated by state governments, pays for health care of individuals with low incomes, children who qualify for public assistance, and individuals who are legally blind or disabled

• Free or low cost

Worker’s compensation

Plan providing treatment for workers injured on the job

• Administered by the state

• Payments are made by employers and the state

• Pays for health care and lost wages

• Prevents employees from suing

Tricare

Department of Defense health care program for military personnel

• Active duty members and their families

• Survivors of military personnel

• Retired members of the Armed Forces

Barriers to communication

• Hearing loss or deafness

• Visual impairment or blindness

• Speech impairment or aphasia (loss of power to use or comprehend words)

• Physiological barriers

  • Caused by prejudice, attitudes, emotions, and personality differences

  • Based on appearance, economic status, etc.

• Cultural diversity

  • Beliefs and practices regarding health and illness

  • Language

  • Eye contact

  • Dealing with terminal illness or sever disability

  • Touch

Recording and reporting information

• Important to make a proper diagnosis

• Important to pass correct information on to other health care providers

• Important to be accurate

• Use of all of the sense by health care workers to make reports

  • Sight

  • Smell

  • Touch

  • Hearing

  • Subjective observations

    • Cannot be seen or felt, usually symptoms or statements of complaint

  • Objective observations

    • Can be seen or measured, signs

Cultural diversity

Differences among individuals based on cultural, ethnic, and racial factors

• Other factors of diversity:

  • Race/ethnicity

  • Disability

  • Religion

  • Socio-economic status

  • Gender

  • Age

Heath care beliefs

• Most common health care system in United States is biomedical health - “Western” system

  • Illness caused microorganisms, diseased cells, and aging

  • Treatment aimed at eliminating microorganisms, preventing disease

  • Teaching self-care

  • Using medications and technology

• Health care beliefs vary greatly

Criminal law

Deals with the wrongs against a person, property, or society

• Ex: practicing without license, illegal possession of drugs, narcotic misuse, theft, sexual assault, murder

Civil law

Legal, relationship between people and the protection of a person’s rights

• Ex: torts and contracts

Types of torts

• Malpractice

• Negligence

• Assault and battery

• Invasion of privacy

• False imprisonment

• Abuse

• Defamation

Malpractice

Failure of a professional to use the degree of skill and learning expected in a profession, resulting in injury, looks, or damage to the person receiving care

• Ex: physician not administering the correct medication while conducting routine medical procedures

Negligence

Failure to give care that is normally expected by a person in a particular position resulting in injury of a person

• Ex: using faulty equipment

Assault and battery

Threat or attempt to injure (assault), unlawful touching of another without consent (battery), often used together

• Ex: performing a procedure after a patient refused permission

Invasion of privacy

Part of HIPPA, unnecessarily exposing an individual (physical invasion of privacy), revealing personal information without consent (informational invasion of privacy)

• Improperly draping or covering a patient

False imprisonment

Restraining or restricting an individual’s freedom without authorization

• Ex: keeping a patient hospitalized against their will

Abuse

Physical harm, pain, or mental anguish

• Physical: hitting, restraining movements, deprivation of food and/or water, not providing physical care

• Verbal: speaking harshly, swearing, shouting, writing threats, abusive statements

• Psychological: threatening harm, denying rights, intimidating, ridiculing, threatening to release information

• Sexual: any sexual acts, gestures, or suggestive behaviors

Defamation

False statements that cause ridicule or damage to reputation

• Slander: spoken information

• Libel: written information

• Ex: telling others a person has a drug problem if another condition exists

Health Insurance Portability and Accountability Act (HIPPA)

1996, required Establishment of standards to protect health information

• Health care providers must inform patients about how health information is used

• Need signed consent before medical records are shared for diagnosis, treatment, billing, insurance claims, family members, etc.

• Patients must see and obtain copies of records

Body cavities

Spaces within the body that contains vital organs

Dorsal cavity

One long, continuous cavity in the back of the body

• Cranial: contains the brain

• Spinal: contains the spinal cord

Ventral cavity

Larger than dorsal cavities, cavities separated by diaphragm

• Thoracic cavity: located in the chest, contains the esophagus, trachea, bronchi, lungs, and heart

• Abdominal cavity: contains stomach, small intestine, most of the large intestine, appendix, liver, gallbladder, pancreas, and spleen

• Pelvic cavity: contains bladder, reproductive organs, and last part of large intestine

Integumentary system

Pertaining to the skin, covers the body and organs, contains several kinds of tissues

• Functions:

  • Protection

  • Sensory perception

  • Temperature regulation

  • Storage (fat, glucose, water, etc.)

  • Absorption

  • Excretion (eliminate salt, waste, water)

  • Production (vitamin D)

• Important structures:

  • Epidermis: outermost layer of skin

  • Dermis: contains connective tissue blood vessels, nerves, sweat glands, hair follicles

  • Hypodermis: innermost layer, made of fatty tissue, connects skin to muscles

Skeletal system

Human body 206 bones, joints, ligaments, and cartilage

• Functions:

  • Framework

  • Protection

  • Levers (muscles attach to bones to produce movement)

  • Production of blood cells

  • Storage (red and white blood cells)

• Important structures:

  • Bones: calcified organs

  • Joints: areas where two or more bones meet, allow free movement between bones

Muscular system

Bundles of muscle fibers held together by connective tissue, human body has over 600

• Functions:

  • Responsive (respond to stimulus)

  • Contractility

  • Extensibility (able to be stretched)

  • Elasticity

• Important structure:

  • Cardiac muscle: found in the heart

  • Smooth muscle: found in walls of hollow organs

  • Skeletal muscle: attached to the body’s skeleton

Nervous system

Complex system that coordinates all activities of the body to respond and adapt to changes

• Important structures:

  • Neuron: nerve cells

  • Spinal chord: connected to the brain

  • Brain: body’s master controlling system

Special sense

Systems that have organ dedicated to the senses

• Important structures:

  • Eyes: organs that receive impulses from light rays, transmit impulses to the brain for vision

  • Ears: organs that receive sounds waves, transmit impulses to the brain for hearing

  • Nose: organ that receives chemicals, transmits impulses to the brain for smell

• Other senses:

  • Touch: receptor located all over body, mostly in skin

  • Taste: receptors located in mouth

Cardiovascular system

Transports nutrients, oxygen, and waste throughout the body

• Important structures:

  • Heart: hollow muscular organ

  • Blood vessels: tubular structures carrying blood through tissues and organs

  • Blood: fluid connective tissue containing cells, nutrients, and waste

    • Erythrocytes: red blood cells, oxygen carrying cells

    • Leukocytes: white blood cells, fight off infections

    • Plasma: liquid portion of blood, contains water and dissolved substances

Lymphatic system

Works in conjunction with the blood to remove wastes and excess fluid from tissues

• Important structures:

  • Lymph: water-like fluid that forms when plasma diffuses into tissue space, composed of water, nutrients, salts, oxygen, carbon dioxide, and hormones

  • Lymphatic vessels: located throughout the body, transports lymph

  • Lymph nodes: (glands) filter lymph, remove pathogens, dead cells, and impurities

Respiratory system

Responsible for taking in oxygen and removing carbon dioxide (waste product)

• Important structures:

  • Nose: warms and filters air

  • Pharynx: throat

  • Trachea: windpipe, carries air between pharynx and bronchi

  • Bronchi: carries air to lungs

  • Lungs: located in thoracic cavity, exchange gasses with internal and external environment

Digestive system

Responsible for physical and chemical breakdown of food so it can be taken to the bloodstream and distributed to body cells and tissues

• Alimentary canal

• Accessory organs

• Important structures of alimentary canal:

  • Mouth: food is tasted, and broken down physically (chewing) and chemically (saliva)

  • Esophagus: hollow tube that takes chewed food to stomach

  • Stomach: large hollow organ, produces gastric juices to further digest food

  • Small intestine: where most of digestion occurs, nutrients absorbed into bloodstream

  • Large intestine: water absorption, vitamin production, elimination of indigestible materials

• Important accessory structures:

  • Liver: produces bile to break down fat in digestive tract

  • Gallbladder: stores bile

  • Pancreas: produces enzymes to digest food

Urinary system

Removes waste and excess water from the body

• Important structure:

  • Kidneys: filters blood to remove toxins and water, produces urine

  • Bladder: hollow muscular organs, stores urine until elimination

  • Urethra: tube that carries urine outside the body

Endocrine system

Group of glands that secrete substances into the bloodstream

• Hormones: chemical substances produces and secretes by endocrine glands

• Functions

  • Stimulate other endocrine glands

  • Regulate growth and development

  • Regulate metabolism

  • Maintain chemical and fluid balance

  • Reproduction

Types of growth and development

• 4 main types of growth and development during life stages

  1. Physical: body growth, height, and weight changes, muscle and nerve development, changes in body organs

  2. Mental or cognitive: intellectual development, problem solving, judgement, dealing with different situations

  3. Emotional: feelings (hate, joy, love, fear, etc.)

  4. Social: interactions and relationships with other people

• Each stage establishes foundations for the next stage

• Growth and development proceeds in an orderly pattern

• Rate of progress differs among individuals

  • Factors: environmental, social and emotional, cultural, genetic

Hospice care

Palliative care (support and comfort)

• “Die with dignity and comfort”

• Provide hospital equipment

• Free medications

• Counseling

Common conditions due to poor nutrition

• Hypertension

• Atherosclerosis

• Diabetes

• Malnutrition

Hypertension

High blood pressure

• Caused by excess amount of fat or salt in diet

• Can lead to heart, blood vessel, and kidney disease

Atherosclerosis

Narrowing of arteries due to an accumulation of fatty substances (plaque) in blood vessels

• Caused by diet high in fat and cholesterol

• Can lead to heart attack or stroke

Diabetes

Metabolic disease caused by an insufficient secretion or use of insulin (from pancreas) leading to an increased level of glucose in the blood

• Could be hereditary with early onset (type 1)

• Caused by obesity, lack of exercise, and diets high in carbohydrates and sugars (type 2)

• Many health effects

Malnutrition

The states of poor nutrition

• May be caused by diet or illness

• Can occur in obese or underweight individuals

• Can lead to depression, hair loss, irritability, muscle and skeletal defects, and death

Essential nutrients

Chemical elements found in food used by the body to perform body functions

• Must be replaced when used

• Divided into 6 groups

  • Carbohydrates

  • Lipids

  • Proteins

  • Vitamints

  • Minerals

  • Water

Carbohydrates

Major source of readily usable energy and structural material, commonly called starches and sugars

• Sources: bread, milk, pasta, whole-grain foods, etc.

Lipids

Large class of organic compounds, basis for energy, insulation, and protection

• Sources: oils, meat, cheese, butter, etc.

• Triglycerides: energy storage, temperature regulation, protection, and structural material

• Phospholipids: protective barrier around cells (cell membrane)

• Sterols: cholesterol, chemical messages (hormones)

• Fats are classified into two groups

  • Saturated: solid at room temperature, found in animal based foods

  • Polyunsaturated: soft or oil at room temperature found in plant based foods

Proteins

Basic components of all body cells, used for building and repairing tissue, regulating body function, preventing disease, and providing energy

• Made from amino acids

• Sources: meats, eggs, cheese, beans, etc.

Vitamins

Essential organic compounds important for metabolism, tissue building, and regulation of body processes

• Well-balanced diet should provide all vitamins needed

• Vitamin deficiency and excess vitamins can cause disease

• Antioxidants: help protect the body against harmful chemicals by preventing cell damage

Minerals

Inorganic elements found in all body tissues

• Regulate body fluids

• Contribute to growth

• Aid in building tissues

Water (not a nutrient)

• Found in all body tissues and cells

• Essential for digestion

• Makes up blood plasma

• Moves nutrients and waste

Utilization of nutrients

• Digestion

• Absorption

• Metabolism

Digestion

Process by which the body breaks down food into smaller parts and changes food chemically as it moves through the digestive system

• Mechanical digestion - chewing, churning of stomach muscles

• Chemical digestion - mixed with saliva, gastric juices, enzymes

Absorption

Blood or lymph capillaries pick up digested nutrients and carried to every cell in the body by circulatory system

• Mostly occurs in small intestine

• Water, salts, and vitamins absorbed in large intestine

Metabolism

Process in which nutrients are used by cells to building tissue, providing energy and regulating body functions

• Energy and heat (byproduct) are released

Calorie

Unit of measurement for the fuel value of food

• Caloric value - number of calories in a certain food

• Nutritional calorie = 1 kcal (4.18 kJ)

• Carbs and proteins: 4 calories/1 gram

• Fats: 9 calories/1 gram

• Vitamins, minerals, and water: 0 calories/1 gram

Basal metabolic rate (BMR)

Rate at which the body uses energy for maintaining without doing any voluntary work (resting metabolism)

Microorganisms (microbe)

Microscopic organism found everywhere in the environment including on and in the human body

• Many are part of normal flora of body

  • Ex: skin, nose, throat, mouth, gut

• Many are beneficial - help maintain certain body processes

  • Ex: aid in digestion and help fight against other bacteria

Pathogens

Microorganism that cause infection and disease

• Require dark environment, food source, appropriate temperature, and moisture to survive and reproduce

• Aerobic organisms: organisms that require oxygen to live

• Anaerobic organisms: organisms that live and reproduce in the absence of oxygen

• 6 main classes

  • Bacteria

  • Protozoa

  • Fungi

  • Rickettsia

  • Helminths

  • Viruses

Bacteria

Simple, single-celled organisms that multiply rapidly

• Classified by shape and arrangement

  • Cocci: spherical, occur in pairs

  • Bacilli: rod-shaped, occur singularly, in pairs, or in groups

  • Spirilla: spiral shaped

• Antibiotics used to treat bacterial infections

  • Overuse and misuse cause resistance

  • “Superbugs”

Protozoa

One-celled animal-like organisms often found in decaying materials, feces, insect bites, and contaminated water

• Can be free-living or parasitic

Fungi

Organisms that feed off of decaying organic matter, can be single-celled or multi cellular

• Not all are pathogenic, usually single-celled

• Only killed by antifungal medications

  • Must be taken long term

  • Expensive

  • Can cause liver damage

Rickettsia

Group of related bacteria that are parasitic organisms

• Commonly found in fleas, ticks, live, and mites

• Most are zoonotic

  • No human to human transmission

• Transmitted by bites from other organisms

• Antibiotics used to cure disease

Helminths

Multicellular parasitic worms

• Live in and feed on hosts

• Life cycle includes in host (living) and out of host (egg/larval) stage

• Transmitted by investing eggs or larvae through contaminated food, or water, or entering the skin